Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan 48109-5312, USA.
Otol Neurotol. 2011 Oct;32(8):1270-2. doi: 10.1097/MAO.0b013e31822e0e73.
Document the use of transcanal labyrinthectomy to treat disabling attacks of vertigo after unilateral cochlear implantation.
A 46-year-old woman with severe-profound bilateral sensorineural hearing loss secondary to enlarged vestibular aqueducts underwent cochlear implantation for her right ear with a Nucleus Freedom device. The surgery was uneventful, and postoperative imaging confirmed that the electrode was positioned properly. She developed episodic vertigo 10 to 14 days after the implant surgery, which failed to improve with aggressive vestibular rehabilitation therapy. Plugging of the round window for possible perilymphatic fistula did not relieve her symptoms.
Right transcanal labyrinthectomy supplemented by filling the vestibule with gentamicin-soaked Gelfoam and then a customized vestibular rehabilitation program.
Comparison of vestibular symptoms and cochlear implant performance before and after transcanal labyrinthectomy.
The patient had immediate relief of symptoms, and the function of the cochlear implant was not adversely affected.
Transcanal labyrinthectomy may be an effective method to ablate the vestibular end organ after unilateral cochlear implantation. It can offer relief of disabling vertigo without adversely affecting the performance of the implant.
记录经耳道迷路切除术治疗单侧人工耳蜗植入后致残性眩晕发作的情况。
一位 46 岁女性，因前庭导水管扩大导致双侧重度-极重度感音神经性听力损失，行右侧人工耳蜗植入术，植入体为 Nucleus Freedom 装置。手术过程顺利，术后影像学检查确认电极位置正确。植入术后 10-14 天，她出现阵发性眩晕，经积极的前庭康复治疗后未见改善。鼓阶堵塞术（可能为迷路瘘管）也未能缓解她的症状。
行右侧经耳道迷路切除术，同时用庆大霉素浸泡的 Gelfoam 填充前庭，并随后进行定制的前庭康复计划。
比较经耳道迷路切除术前和术后的前庭症状和人工耳蜗植入性能。
患者症状即刻缓解，人工耳蜗植入功能未受不良影响。
经耳道迷路切除术可能是一种有效的方法，可在单侧人工耳蜗植入后消融前庭终器。它可以缓解致残性眩晕，而不会对植入体的性能产生不利影响。
